PREFACE

The National Guidelines for Laboratory Diagnosis of Malaria is a document consisting of comprehensive guidelines formulated to assist laboratory personnel as well as other health professionals in Ghana who use and interpret diagnostic tests for malaria. The guidelines include precise and concise information serving the purpose of a first-hand book as well as a source of laboratory instruments and tools to support malaria diagnostic work in Ghana. The Guidelines use the findings of the 2008 National Laboratory Assessment that concluded that a) Half the laboratories reported that interruption of power supply and poor access to clean water impacted negatively on capacity to provide quality malaria diagnostics; b) Less than half the laboratories were open 7 days a week and only one third were open 24 hours a day; c) More than half the laboratories (55%) had only one or no staff trained in malaria diagnostics; d) The number of positive test results compared to malaria cases reported ranged from 10 20%; f) Less than half the facilities had quality assurance protocols in place; g) Less than half the facilities prepared blood films rated as good; i) Only 55% laboratories had received a supervisory visit in the previous 6 months and only 20% of these included any kind of blood slide review; j) 45% of laboratories lacked spare microscope bulbs and about one sixth reported Giemsa stockouts; k) for clinical assessment of fever, only 59% of health facilities had a functioning otoscope. Knowing the difficulties encountered with respect to laboratory diagnosis of malaria in Ghana, it was found necessary to establish a reference document where essential basic information can be found to serve as a guide for laboratory personnel, clinicians and health facility managers on strengthening diagnostic practices for malaria in Ghana. These practices should not vary from one institution to the other, but rather there is need for a unified approach across the country. it is this need that led to the development of this document. Currently, the scope of laboratory diagnostics in Ghana is rather low, especially for malaria. Most prevalent diseases present themselves as fever which can be mistaken for malaria. Hence, the earlier these guidelines are adopted and enforced the better for all the people of Ghana. Health workers can then confirm if patients have malaria and can provide the correct treatment. This will go a long way to reducing the number of malaria cases recorded, since malaria is currently over-reported as a major disease burden in Ghana.

The document is intended to be used primarily by laboratory personnel specifically laboratory technicians, technologists and all other health professionals who perform laboratory tests. The documents should also be used by any category of person situated in the field of diagnostics such as clinicians, who play an important role in the diagnostic process. In fact, all health workers and interested persons in laboratory work can adopt it as a handbook and a resource. The language used in this document is intended to be simple, concise and precise, making it easy to read and use. There is a list of abbreviations and glossary of words to guide its users as well as divisions made up of chapters and sections with bulleted points, diagrams and illustrations. Thus, this document seeks to inform, enlighten and improve the knowledge of laboratory personnel and laboratory users alike. It is our earnest desire that the use of this handbook will go a long way to help in the fight against malaria in Ghana